By Peter M. Abel, M.D.
Medical Director,
Prevention Center for Cardiovascular Disease
Cardiocascular Institute of the South

Yes, certain vitamins do appear to have significant potential in the treatment of atherosclerosis -- the buildup of cholesterol plaque in the heart's own arteries which triggers most heart attacks. However, the dosages at which these vitamins would be beneficial are enormously greater than the trace levels at which they serve as nutrients. At those levels, their use must be supervised by a physician.

Niacin (Vitamin B3) and Vitamins C, A and E are currently being used or investigated as medications in the treatment of atherosclerosis. Niacin, in particular, is widely used for its ability to lower the levels of triglycerides and plaque-producing low density lipoprotein in the blood, while raising the level of high-density lipoprotein (HDL) -- the so-called "good" cholesterol.

The interest in Vitamins C, A and E stem from their antioxidant properties. Antioxidants interfere with the complex process through which LDL cholesterol starts plaque formation. Certain oils -- among them olive and canola (rapeseed) oils -- are also known to possess antioxidant properties, which may explain why people who use them as the predominant oils in their diets have a lower rate of coronary artery disease. Some animal studies and at least one human study suggest that Vitamin C also improves the level of protective HDL cholesterol.

These substances are needed by the body for nutritional purposes in very small amounts, and are readily available over the counter as supplements. This, I fear, might lead to unsupervised self-medication by those who think that they are harmless nutrients.

At the megadose levels at which they are prescribed to certain (but by no means all) heart patients, they are definitely not without potential side effects, some of which are severe.

All but Vitamin C are fat soluble, which means they will accumulate in body fat -- potentially to toxic levels. Their toxic effects include liver abnormalities, bleeding, nausea, gastrointestinal irritation, skin flushing, skin abnormalities and fatigue.

Vitamin C, which is water soluble, and thus not as readily retained by the body, still can be poisonous at sufficiently high levels.

Leave any decision about the medical use of vitamins to your doctor!

&copy 1995 Cardiocascular Institute of the South

For further information, call Jane Arnette, Cardiocascular Institute of the South/Houma, 1-800-425-2565, or Jim Keyser at 1-800-848-2715. E-mail questions or comments to: jakeyser@cardio.com.

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